Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “Prostate cancer”

Weathering the Storm…Nine Months Later but Who is Counting

Weathering the Storm...Nine Months Later but Who is Counting

Weathering the Storm…Nine Months Later but Who is Counting

At six-o’clock in the morning on Sunday I am sitting in my hotel room in Kansas City, Missouri listening to the thunder as the tail end of a violent Spring storm passes by. Looking at the weather radar I can see another small cell approaching from the southwest. Last night the weatherman reported that there was a 60% probability that one would be exposed to a violent storm, possibly a tornado during the afternoon hours when I will be in Denver. Lucky me.

All this got me to thinking that I was and always have been lucky. Most recently, when I was diagnosed with aggressive prostate cancer in September of 2012. What could be lucky about hearing the words, “You have cancer,” you ask? At the time, I didn’t think it so lucky either but then, after all the testing, the poking and prodding, I learned that the tumors were likely (but not positively) encapsulated in my prostate and that surgery would be the most aggressive ‘cure.’ The decision to operate took place in October but, because of the swelling of the prostate due to the needle biopsy, surgery had to wait until late November. That thirty day run-up to surgery was a nervous time, a time in which I thought a lot about my own mortality.

As long time readers know, the surgery was successful, the tumors were, in fact, contained within the prostate; it became clear that life would go on. Of course, I was left with two significant side-effects of prostate surgery. I suffered significant incontinence requiring me to wear diapers for the next five months. As I write this today, I am confident that the incontinence will not be a problem much longer if at all.  This, of course, answered a significant question I had for many years, namely, “Just who would wear Depends for Men anyway?” The surgical procedure was said to be nerve sparing so that sexual functioning would not suffer. Oops, that side-effect remains intact. I think of this as a small price to pay for a long life expectancy; who knows, I’m told this is likely not permanent either.

Since the surgery, however, I have suffered two major setbacks. First, I had a significant urinary tract infection, one that was resistant to many antibiotics, requiring that a permanent line be attached to a vein in my arm for daily injections of some potent antibiotic. While this seemed to do the trick (the infection is gone) I was diagnosed with chronic kidney failure with a kidney function of under 20%. While the reason for this seems to baffle both my internist as well as a kidney specialist I am seeing, the last kidney function test showed a marked improvement in kidney function. The worst seems to be over. Lucky again.

Good, because on Wednesday I will arrive in Las Vegas to play a little poker. While I don’t think of poker as a game of chance, winning always involves a bit of luck as well as a great deal of skill. So, as I go to Las Vegas, I’ll wear the cloak of luck I seem to have been wearing for the past 70 years, one that has allowed me to weather most every storm I have encountered. 

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Belonging . . . The Vagaries of Community or The Fragmented Self

The Vaguaries of Community

The Vagaries of Community

Belonging . . . The Vagaries of Community

Belonging . . . The Vagaries of Community or the Fragmented Self

I created the splash art on the right as a representation of the vagaries of the whole idea of what it means to be a member of a community. Loosely defined, a community consists of a group of people with common interests, skills or vocations. Based on that definition I belong to many communities. Professionally, as a retired professor of language and literacy, I belong to a broadly defined community of reading teachers and specialists as well as to a broadly defined community of English educators with a concentration in the teaching of writing. Additionally, I belong to a community of prostate cancer patients with a current sub-set of prostate cancer survivors (although that could change in the future). I also belong to a religious community because I identify as a secular Jew with an interest in Jewish texts and how to interpret those texts. This latter identification, however, does not connect me to a community of religious/practicing Jews in any way. I also belong to a recovering community of alcoholics belonging loosely to Alcoholics Anonymous having put a cork in the bottle over 22 years ago. In fact, I could likely list dozens of additional communities that I loosely belong to but I don’t actually feel the need to do so at this time. The point is that the lines between what constitutes a community are blurred; they are noticeable covered over by other interests while often overlapping and turning back into themselves.

The communities I feel closest to are independent of my membership. What do I mean by that. First, they existed before I had any active memory and they will exist when my active memory ceases to be. My birth nor my death have any impact on the existence of these community groups. In fact, these communities are based on the ethical idea of extending oneself for the welfare of the other. I want to look briefly at three specific examples: first I explore the Chabad as a place of both refuge and learning that is open to all without reservations, then I examine Alcoholics Anonymous as a more specific ethical engagement, one recovering alcoholic helping another alcoholic for their mutual benefit, a slightly different twist on the fundamental ethical obligation. Finally, I briefly look at the social construction of race and ethnicity in light of my own existential experience and ask what it means to be able to free oneself from the shackles of stereotype; from external definitions and categorizations.

The Chabad as Community

As those who follow this blog know, I am exploring Jewish texts in order to better understand how to think in Jewish. This knowledge will, as I see it, make me into a more well-rounded thinker for two reasons. First, by learning to attack an issue from different perspectives, I will be better equipped to come to more thoughtful and, perhaps, more relevant conclusions. Secondly, learning to think in Jewish fills in a number of gaps in my own education and religious heritage. Both reasons are selfish on my part. What is interesting, however, is that when I approached Rabbi Mendel of the Elgin Chabad, his response was immediate and, as I expected, fully welcoming. He placed himself in my path without reservations offering to assist me in any way he possibly could to help me in my quest.

This notion of community is one based on the clear notion of being available to those wishing to belong. All I had to do was present myself to the community and I was immediately included in the goings on of the group, no questions asked. The Chabad existed long before I was born and will continue to exist long after I am gone; a community of Jews, some observant and some totally secular, coming together for the common goal of learning about their heritage. While I believe there are many roads to this very kind of learning, for most groups one must hang around for some period of time before they are accepted into the community. They must show up on a regular basis, show up when expected and participate to a level that the group expects of them. Not so with the Chabad. Just showing up is good enough for them. Period.

Alcoholics Anonymous as Community

There was a time in my life when suicide seemed to be a reasonable cure for the pain of what drinking was doing to my life. I saw no way out of the trap alcohol had for me. While the journey to AA was long and difficult, at my first meeting of AA, the day I admitted to myself and to a room full of strangers that I was an alcoholic, I felt a weight lifted off my shoulders that felt like the release of a thousand pounds. At my very first meeting of AA I was accepted by those in the room, by those who were there before me. I had no idea why they were being so nice but I did have the sense that I was clearly in a place where I belonged.

Not until sometime later, when I had spent some time in AA meeting rooms, did I begin to understand the power of one alcoholic helping another alcoholic stay sober. Of all the people in the entire world, only another alcoholic can laugh at the tragic circumstances that brought us together in the first instance. While limited to serving anyone with a desire to stop drinking, AA’s mission is given without reservation. My obligation if approached by another alcoholic is to provide whatever assistance is within my power to help that individual stop drinking. From this friendships develop that last a lifetime but that are first and foremost anchored in the simple fact that I do not wish to take a drink today. AA was around before I was born and will be around long after I am gone because its call to community is strong.

Both of these communities have one other thing in common, they are tied together by ritual both in the form of liturgical practices and custom. I have been to AA meetings in any number of places and they all take on the same character and structure. Praying at the Chabad differs little from practices at any other Jewish religious organization. It is clear and recognizable even though they take on a local character as well.

Ethnicity and Race

When my grandparents got off the boat at Ellis Island as they immigrated to the United States from Eastern Europe in 1898 their immigration records listed their race as Hebrew. Now, when I am asked to fill out a government form that asks for racial information I am given any number of choices but Hebrew is not among them. While I was young, being indoctrinated by Sunday School teachers at the Reform Jewish congregation that my parents belonged to we were constantly told that Judaism is a religion and not a race. The assimilationist strain ran quite deep in the Reform movement at that time, the late 1950’s through the early 1960’s. As I grew older, however, I found that I did not always fit in to a broader, more Christian, community. My first experience with the whole thing was a flat rejection from all college fraternities except the Jewish fraternities on campus. I didn’t think much of it at the time but it was a precursor of things to come. Sometime, in my mid 50’s, right after I earned my doctorate in language and literacy, I made a conscious decision that assimilation wasn’t working out quite so well as I was led to believe. I began to think more about the ethnic and racial categorization that was placed upon my grandparents, that of Hebrew, and I began to think about just how the very idea of race and ethnicity are socially constructed. I came to the conclusion that race and ethnicity can, and should, exist side by side with social responsibility. One can be a good citizen and yet identify with a group outside the norm. W.E.B. DuBois called this idea acculturation, an understanding of the dominant culture while maintaining a strong identity with one’s own core group. Since the time I began to think about just where I belong in the ‘human race’ I check the other box when I am asked about race or ethnicity on a form. I do not elaborate, I simply protest the very idea that one fits into a stereotypical category that serves to define one’s status in society and power over others.

Questions that Remain Open

Because these communities precede me and will exist without me, can I truly claim membership? Because I belong to any number of groups, some core and some peripheral, does that belonging fragment me into pieces that emerge only when I am within a specific place and time surrounded by fellow travelers? Or, should I even seek to try to identify with any group, any community, even the core community that forms the ethical core of being in terms of membership and simply live as a sentient being in the river of time beholden to no one or nothing that serves to classify me or put me into a cubby hole?

It is Raining Outside Chicago In January

It is Raining Outside Chicago In January

It is Raining Outside Chicago In January

It is raining, well not quite rain, rather a mixture of rain and sleet, freezing rain I suppose. This means that the electrical grid will be stressed to its limits this evening as temperatures drop into the mid-twenties. Tomorrow, however, the forecast calls for temperatures in the mid to high forties and it is still January. Something is awfully wrong with the weather. Of course, I live in the United States, the land of denial (that’s right the Untied States not Egypt). Global climate change is only a mythological story told by liberals in order that they might spend more money and grow the size of our government or so goes the tale told by the denial group. But temperatures in the high forties and low fifties in January in Northern Illinois are simply not normal. Perhaps it is time to wake up and smell the roses (that may bloom in February if this keeps up) before the world my grandchildren inherit from us is destroyed.

That being said, after all it is good to rant once in a while, I spent an interesting weekend at the Chabad of Elgin, where the Rabbi and his wife hosted a Friday night dinner. The evening included both a Shabbat service, a dinner and Shabbat games played by a raucous group of folks attending this event. The food served featured the seven native fruits of Israel including: dates, figs, pomegranates, sesame seeds, olives, apples and oranges (if memory serves me correctly). The food was simply outstanding, rich in tradition with a modern presentation that left everyone there satisfied. The hit of the evening for me was a potato kuggel, a baked potato pudding, that swept me back nearly 60 years to my grandmother’s table and her outstanding potato kuggel. I even asked for the recipe it was that good.

Part of the evening was spent talking to one of the regular attendes at our weekly torah study group. We see each other on a week to week basis but never really get a chance to talk much. Spending time building this relationship was both interesting and enjoyable. It turns out that he is a “Jew by Choice” having converted to the religion I was born to. Because we come to the table with such different perspectives our conversation explored nuanced belief; how, for example, I could be so interested in religious texts while I simply do not believe in a God (or gods for that matter) and while no conclusion was reached, I found myself thinking more clearly than ever about the differences between belief and non-belief, between faith and rationality. I suppose that is a good thing but I cannot yet draw any conclusions about the conversation we engaged in.

At one point in the evening Rabbi Mendel told us an interesting tidbit of information. We were celebrating the holiday of Tu Bish’Vat, the festival of trees, a holiday in which Jews traditionally eat fruit. The holiday that celebrates the harvest and, by implication, fruit, Sukkot, doesn’t have a tradition of eating fruit at all. Curious. But, needless to say, he found a lesson in all that. Eating of fruit on Tu Bish’Vat symbolizes the potential in the fruit tree, the very reason for the existence of the trees in the first place. Celebrating by eating fruit on this holiday reminds us of all of the work to nurture the trees, to pull the weeds, water the orchard and so on. It reminds us of the purpose of nature harnessed. The harvest, on the other hand, the picking of the fruit, represents a period of dormancy that doesn’t require a special food to remind us that the seasons turn in order. Now these are stories I can understand. They are simple, almost folksy, reminders of an ethical life lived encapsulated by infinity. The stories lend purpose to an otherwise absurd life, a life in which purpose often eludes us.

One last thing, I am actually feeling quite giddy today. I spent the last two nights sleeping through the night, the first time since my prostatectomy. Not only that, but in the morning the only thing in my Depends for Men was the baby powder I put in before I went to bed. I take this as a sign that things are actually improving. I am pleased to report this progress as it gives me something to look forward to. Yea!!!

Always Already Being In The Material World

Always Already Being In The Material World

Always Already Being In The Material World

To borrow a phrase from Martin Heidegger without necessarily committing to its meaning, being-in-the-world adequately represents the notion of the existential moment. If I could phrase it differently than Heidegger I would strip it of its ontological references while incorporating the notion of representing an illusory phantom of the trace of memory and a projection into the future. In Levinas’ terms, this is represented better by the notion of hypostasis, the question of the infinitely brief moment of existential time while merging the idea of the trace remembered and the future desired, both of which are measured by ever fading memory or ever more fantastic dreamt of futures. In brief, existential time is a simulacrum of the conjoining of past/future, while cleverly disguising both within a true sense of security of past events and a desired sense of future certainty. Nothing, however, exists outside of this very moment of existential time; all the rest is merely a ghost or a projection on a screen of hope; something like Plato’s images on the cave wall without the reference to forms.

Going beyond the ontic nature of Heidegger’s being-in-the-world, Levinas focuses on the idea that hypostasis focuses on the interiority of solitude in which one experiences existential time; the trace of memory and those projections for the future are clearly personal, not able to be shared with any other human being. If left to its own resources, Heidegger insists, the self would be so consumed with its own interiority that it could not relate to the exterior world other than to evaluate the entirety of that world as objects of the self with being incorporated in the objective relationship with the objects, including the human objects, in the world. Levinas is critical of this position arguing that one can only understand being by and through the social interaction with the other, by responding to the call of the other without reservation or expectation of reciprocation; to make oneself present in the world in order to be responsible for the welfare of the other without reservation or expectation of reciprocation. In this sense, being-in-the-world turns Heidegger on his head by proclaiming that ethics trumps ontology; that response-ability, the ability to respond to the call of the other from wherever it originates is a fundamental obligation of the ethical human being, denying the interiority of the self as more important than the self existing as a social being evidenced by its commitment to the exteriority of the world one encounters in this very moment of existential time.

I exist in this world in order to be of service to the other, to extend my hand whenever and wherever I hear the call of the other asking for help. Must I answer each and every call from the other? No, but I must answer the calls for which I am best equipped. For me, as a personal being existing in the world, I have two major callings. I will answer the call of anyone with a desire to stop drinking by extending my hand and offering the support I can and must offer. I do this because I am a recovering alcoholic with over two decades of not drinking. Recently, because of my diagnosis of prostate cancer I announced my presense to any and all who have the same or similar diagnosis; I will answer the call of anyone with prostate cancer by extending my hand and sharing my experience, strength and hope. The choice of these two ‘causes’ does not preclude my being responsible in other situations; it simply means that I have chosen to priortize my personal sense of responsibility in these two arenas at this very moment. It seems that I recognize my existence within the bounds of the spirit of Alcoholics Anonymous and the community of men diagnosed with prostate cancer as well as those men who desire to end prostate cancer as the second leading killer of men in the United States.

 

Showing Improvement

Showing Improvement

Showing Improvement

I am old enough to realize that every single new day, in fact every single moment of existential time, brings with it something new. New challenges abound while carefully balanced by new things for which to be grateful. Being-in-existential-time, experiencing first hand the lived-experience, is something to be savored, enjoyed and embraced. This all works when one looks outside of oneself, finds ways to serve, to engage with others in a face-to-face encounter. It does not work when, in the depths of emotional or physical pain one turns to the interiority of the self because all there seems to be is pain or loss that triggers the desire to turn inward. When in pain it is difficult to think of anything else. When I had my left knee replaced six months ago the pain was so severe that I wanted no part of any other human being including my closest family. I saw absolutely no hope for relief. Drugs like toradol provided some immediate relief but that relief lasted but a short period of time. Then, about 3 months post knee surgery, the pain simply disappeared; presto, it was gone. The prostate surgery four months post knee surgery brought a different kind of pain, one that settled into my upper torso, especially around the shoulders and chest. This came from the settling of the CO2 pumped into my guts during surgery. While it was happening I was beside myself but then it left me only it was two days not three months.

The point of this is simply that there is no pain so great as not to resolve itself over time. I am in the middle of such a resolution as I write this. The incontinence suffered as a side effect of the radical prostatectomy I had is beginning to diminish, so much so that I have changed from Depends for Men to Depends Pads for Men during the day. It feels so good to wear cotton underwear and not the rubber pants that are part of the Depends for Men. I feel like I can breathe once again, that the underwear doesn’t stick to my buttocks, feel cold, chafe or bind. The thing that prompted the change was the simple fact that I was using fewer Depends three weeks after the catheter was removed. Leakage is slowing, not stopped. But the simple fact is that things are improving, getting better day by day.

This is, of course, an important lesson to remember. No matter how difficult something may seem at the moment, there is always a bright side to the picture. That old saying, this too shall pass, is quite true so long as one is willing to do the work to extract oneself from the interior of the self. It all comes back to the idea embedded in Levinas’s fundamental ethical obligation, to be of service for the benefit of others, to think of others before you think of yourself, to be ready to answer the call of the other without reservation or expectation of reciprocation. It is this basic idea of getting outside of the self in order to be present in existential time, in the material world, that makes all the difference in living in the world or contained as a hermit within the self.

Being of service to others is a decision made without reservation. It is a decision that rips a tear in the fabric of interiority allowing the self to escape itself in order to live in the world. This tear in the fabric of one’s internal self, once made, becomes the guiding model for one’s lived-experience. This is not to say that the tear cannot be overlooked, especially in the time of great pain, physical or emotional, but once there it becomes the window that allows light to render the darkness moot. The tear in the fabric of interiority is permanent, it cannot be repaired. It remains open even in the darkest of moments, in the times of greatest difficulty. It provides a way back to the material world and the ability to be of service for others.

Beyond My Wildest Dreams

Beyond My Wildest Dreams

Beyond My Wildest Dreams

In October of this year, right after I was diagnosed with prostate cancer, I started this blog as an exercise in thinking about life and my struggle with this potentially deadly disease. I was (and still am) writing for myself yet I am also writing with the idea that perhaps, just perhaps, by my writing I will be available for anyone struggling as I am with their own disease. As of this morning I have recorded over 1,500 visitors to this site; something I never expected or anticipated. Sure, I had a boost in visitors from WordPress when the blog was selected for their Freshly Pressed page and I am grateful for that but it doesn’t explain the fact that so many others follow, comment or like this blog. It provides energy for me to continue to be present for readers no matter what their struggle for as long as I can.

Regular readers may have noticed that I am now using a single graphic, a stylized portrait of me painted on a brick wall. I have a particular fondness for functionalist imagery, stripped to its bare bones while still representing something in the world. I tag the image with the title of the post and let it be.

On another note, as I am writing this I am in some significant pain. Four months prior to my cancer diagnosis I had a total knee replacement in my left knee. I regained almost complete mobility in the knee through hard work and physical therapy. Since my prostatectomy I have been unable to do the exercises that are necessary to keep the knee functional due to the potential strain and weight limitations for lifting resulting on both stiffness and pain in the knee. I am reasonably certain the problem is caused by fluid on the knee but I can’t be sure until I see my orthopedic surgeon on the 4th of January. Who would have ever thought that a side effect of radical prostatectomy surgery would impact my knee?

Finally, on this day after Christmas, I certainly hope everyone had a joyous and restful holiday. While I don’t celebrate Christmas myself, remember I am a Jewish atheist, and I am bothered by the constant commercial clatter of the holiday that begins the day after Halloween and seems endless, I am a champion of diversity and acceptance of the other person, no matter what his or her beliefs are. Would that we could all be like that! Acceptance is the key to serenity if all you do is accept your personal set of circumstances. On a broader scale, acceptance of the other is the more powerful path to peace, love and understanding even when the rest of the world is falling apart around you.

I thank each and every one of my readers for your interest in this attempt to share with you some of my stories of recovery. I wish each one a very Happy New Year. So glad the Mayans were wrong.

Who is the Author of this Text

Writing

Writing

I am sitting around waiting for a call from my urologist. I called this morning to report a bloody discharge in my urine, an unexpected problem. I have no other symptoms, no pain, fever, no nothing except the bloody urine. While sitting around I was looking through a old journal of mine and I found an entry dated 10/23/06, written a bit over six years ago. It began with these words, “Who is the author of a text?”

I passed the time asking a number of questions. Is the one affixing one’s signature to a text, whether by affixing one’s name to a page or by actually signing a document, the same person as the one who wrote the piece? Is the person whose signature is attached to a piece the same person as a reader approaches that text outside of the presence of the author and at an indeterminate time in the future? Am I the same person in this very moment who signed the piece? The same person who wrote the piece in the past tense? The same person when, some unspecified time in the future reads the piece?

Perhaps I am not the same person I was when I began this post. In fact, I began writing in the morning and soon after I began writing my son arrived ready to do some work around the house. We then went to lunch where we spoke about many things including the weather, his drive to Phoenix, pain and the advances in medicine. We discussed my cancer, the treatment and side effects of the surgery. We even went shopping for socks. All of this changed me from the writer I was a few hours ago to the writer I am at this very moment. While the changes may be subtle, they are not insignificant. Every act, whether intentional or not, leaves an infinite number of unintended traces behind, some physical others less so but nevertheless show impact on the future writing.

Am I the same person I was before I was diagnosed with prostate cancer? I don’t believe so! In fact, I can point to major differences in my attitude and approach to my own lived-experience. I know I am more aware of little things, of connections, of reasons for being. No, each and every experience, whether significant or mundane poses a problem that changes one’s approach to life and the challenges we face.

For one to think differently is to argue for permanence in the world, a world in which things are absolute and certain when, in fact, nothing remains the same over time. Truth can only be determined for a particular moment in time and determined by examining all the evidence both pro and con. The truth that is then worked out is what Dewey called a warranted assertion. Once, not so long ago, people believed that there were only four elements that made up the entire universe: earth, water, wind and fire. This was held to be true and inviolate. No one believes that today because of advances in science presented evidence to the contrary. This is but one example of change that makes truth relative to the questions being asked and the evidence being presented for any position.

So here I am writing a text that is fluid in the writing and open to changes in thinking. As a writer, I am writing the text in what I call existential time. When I complete the text I leave it to a reader to explore. The text itself no longer exists in existential time, rather it exists in archival time. As a completed text, I, as author, step aside and leave the text to a reader and while the reader is reading the text in existential time (for the reader) s/he is reading a document that only exists in archival time. For the reader of a text, an archive of the past, the reader invades archival time through an infinite regression into the past, to a time when the very text being read was written and signed by the author, yet the author of the text no longer exists; for the writer, assuming s/he is alive, the time the text is being read is a projection of the past turned forward, a future now, that begs for a reader’s interpretation. In this sense, the past and the future turn into each other and meet at the reader’s now.

What interests me here is how having prostate cancer can inspire me to look at things closely, to experience my own thinking from a time long ago and to begin to rethink the ideas held in them. I approach what I have written not as an author but as a reader. The one who wrote the entry I am exploring no longer exists, I as a reader can gain some insight into the thought process I once had, but that process only appears to me in the trace within the text I signed.

Overlapping Circles of Community

The impossibility of approaching the other (autrui) without speaking to him signifies that here thought is inseparable from expression . . . consist[ing] in the intuition of sociality by a relation that is consequently irreducible to comprehension.
Emmanuel Levinas, Basic Philosophical Writings, p.7

Overlapping Circles of Community

As the new year approaches, less than two weeks away, I think it is important to reflect on the past year, the ups and downs, the natural fluctuation of the randomness of time, in order to digest the traces left behind that continue to affect me. As I age I find that life presents new, often unique, challenges that simply come with getting older. I also find that concurrent with those challenges is a desire to connect with friends and family through increased social contact. Additionally, while I have always been struck by nature, I find myself increasingly being in awe of the beauty and violence of the natural world. Both of these connections require one to approach the other (in the case of social contacts) and the Other (in the case of natural phenomenon) with a speaking, a conversation or perhaps as Levinas equates this use of language, with a (non-theistic) prayer (more like a polite but insistent asking or imploring) said without reservation or expectation.

Two major medical issues seemingly exploded, disrupting my life since May. The first of these required a total replacement of my left knee, a procedure from which I am still recovering. I am no stranger to orthopedic surgery having had two hips replaced and a L3-S1 laminectomy fusing my lower spine with titanium rods and screws but I had no idea how difficult it would be to recover from knee replacement surgery. After three and a half months of physical therapy I regained nearly full extension of the knee but I remain plagued with a stiffness that seems to haunt me during the day.

As if that were not enough, I was diagnosed in September with prostate cancer. Considering that the biopsy of the prostate found an aggressive strain (Gleason score of 4+4) and a spike in my PSA to 23 (a range from 21 to 26 over three samples) there was every reason to believe that the cancer was metastatic. This proved not to be the case on bone and CAT scans but the CAT scan was inconclusive because of the amount of metal surrounding my groin. In consultation with my urologist and internist and long talks with my wife, we decided to undergo a robotic radical prostatectomy, a procedure performed on November 28th, nearly one month ago. Once again I dodged a metastatic bullet when the biopsy of the prostate found the tumor completely contained within the organ and the lymph nodes free of disease. At this very moment I can look forward to many more disease free years.

As a result of the prostatectomy, I am left with two side-effects. I am currently required to wear diapers due to incontinence and I am unable to become aroused. I don’t know if these are permanent or temporary and I am not certain I want to undergo additional surgery to correct them. I meet with my urologist on the 27th of December and expect to have a frank discussion with him to see what he thinks. While he will be handing me off to a new urologist, one of his partners, as he moves to a new position out of town, I believe he will be more than straight forward with me about these two side effects.

So the point of retelling these two medical tales is simply this, for me, most of 2012 was consumed with medical issues. It was also met with family tragedy as my youngest cousin, Steven, passed away from multiple myeloma, a particularly virulent cancer that simply consumed his body but never his spirit. About a month before he died I was in Los Angeles to celebrate a 60th wedding anniversary of my wife’s closest friend’s parents. While there I had breakfast with Steven, my sister and several other cousins. Steven, I believe, knew the end was near but he never let on. We talked, laughed, shared stories of our younger days and, without knowing it, said our good-byes. A month later I was back in LA to attend his funeral.

When I let my family know that I was diagnosed with prostate cancer the outpouring of love and support was absolutely overwhelming. What I learned from my cousin Steven was to never ever give up on life, to live life on life’s terms, to experience every moment of existence as unique and filled with the joy of breath; there will be time enough for whatever the antithesis of celebration might be in the grave so there is no need to feel sorry for oneself for a life well lived.

None of my lived-experience of the past year comes close to my being able to comprehend the consequences of these events. There being no intentionality causing the events to occur (I see the universe we share as a gigantic random number generator where probability trumps intentionality) I find that I take great solace in the long and sometimes quite brief conversations I have had with those closest to me. I am learning to extend myself to others in powerful ways and even find myself making new friends along the way. I am buoyed by a fresh look at the natural world in which I exist and the awe inspiring power ranging from the smallest micro-organism to the power of a tiny river’s capacity to carve a Grand Canyon, to the ravages of a blizzard in winter. Taken together, these events, these conversations, my ability to see the absolute beauty in nature and to be awed by the universe itself make this life a life worth living.

In Every Sorrow There Is Profit

“In every sorrow there is profit” (Proverbs 14:23).

The weather forecast is...rain!How can a sorrow turn a profit? Let me relate this to my own sorrow, my battle with prostate cancer. The words, “You have cancer,” even when these words are somehow expected given the circumstances, are stunning. In my particular case, these words placed me in immediate confrontation with my own mortality. I certainly understood that life itself is a terminal condition; that one cannot expect immortality or at least a corporal immortality. I knew that I was going to die someday but suddenly the prospect seemed utterly possible.

The cancer was discovered through needle biopsy prompted by the fact that my PSA had a range of 21 to 26. The cancer biopsy found about 5% of three samples had a Gleason Score of 4+4, making the cancer itself quite aggressive. In consultation with my urologist, internist and my wife, I decided to follow the recommendation of the urologist opting for a robotic radical prostatectomy, a procedure that would provide me with the best chance for a “cure.” Since my bone scan was negative for metastasis and my CAT scan was mostly negative for metastasis (because I have a great deal of titanium shielding my pelvic area (two replaced hips and a laminectomy l-3 to s-1) the pelvic area being a question mark, the diagnosis of non-metastatic cancer was on hold until the biopsy of the lymph nodes surrounding the prostate. All that was hard to swallow especially when I had to wait a month for the prostate surgery to take place because the gland was swollen due to the needle biopsy procedure.

The instant one learns that one has a potentially fatal disease, prostate cancer is the second leading cause of death in men, the prospect of eternity becomes real. But what exactly does eternity mean? For me, the prospect of eternity means a reversal of the transition of exiting one infinity, a condition that is emergent at the very moment of birth to the transition of returning to that very infinity at the very moment of death.

This transition is one in which one moves from existential time, the lived-experience, to archival (remembered) time, the traces left behind for friends and family and possibly for others outside a direct connection to the self. The first time I heard the words spoken aloud, “You have cancer,” it was like a kick in the head. The last time I experienced such a sensation was when I heard the not unexpected words, “Your father is dead.” Everything stops, stands still, refuses reality. It is the first stage of any sorrow, that of denial. I found a quiet place to sit, to embrace the stillness, the silence that surrounded me. I wanted to be completely alone, to sink into myself allowing me to feel sorry for the loss or potential loss that is approaching. In very real terms, I found myself embraced by and embracing a deep sorrow. In poker terms, however, I had a few outs. Not all the cards were played and not all the possibilities were known.

Infinity

Infinity

I soon discovered the profit promised in the proverb that inspired this post. The strength I had working for me was the fact that I had some outs; that there was the possibility that the surgery would be curative so rather than facing immediate mortality, I would be safe, at least from this disease, for some time to come. This gave me the strength to rethink the ethics proposed by Emmanuel Levinas summarized by what Hillary Putnam called the fundamental ethical obligation: I am responsible for the welfare of the other without reservation or expectation of reciprocity! This fundamental obligation provides one with the ability to live in this very moment, the moment of existence, without projection and without memory in the sense that what is done is done and, without reservation, one cannot dwell on regret as a predominant emotion to the traces of the past.

The sorrow imposed by prostate cancer provided the opportunity to profit from the knowledge that Here I Am! responsible for the welfare of the other, the fundamental ethical obligation, as a call to live ethically in this very moment. Living in this very moment is both exciting and freeing. I can’t imagine living anywhere else.

Here I Am!

Abstract

Abstract

Sometimes I wonder just how many significant opportunities to escape the mundane, day to day activities of life are offered up in a single lifetime. A group I belong to, one that relies on platitudes to make a point, drills into its membership that one must live life on life’s terms. For the most part, that means accepting the humdrum of a random life, one that offers up both challenges and boredom, and mostly boredom. So perhaps the question of escaping the day to day absurdity of the lived experience is not the goal, rather the challenge is to learn to live with the chores of existence while being open to the challenges that sometimes come along.

Challenges appear without notice. There is no announcement that a challenge will present itself on Wednesday at 7:47 AM so be ready. No, challenges strike randomly from apparently nowhere in particular. They are random occurrences that follow the mathematical laws of probability.  Most challenges sort of creep up on you. Once noticed, they don’t seem to have a point of origin. They are suddenly just there, presenting themselves in a way that causes one to remark, “Where did that come from?” Others present themselves suddenly, without any real warning even when a point of origin can be readily identified. The evening after my bone scan and CAT scan, sitting at the dinner table, when my urologist called and said, “You have prostate cancer,” proved to be one of the latter challenges. Those words were like a glass of cold water being thrown in my face, a wake-up call that, while perhaps anticipated, came as a shock.

Challenges offer one some choices. In the case of my diagnosis of prostate cancer, the choices were quite simple. I could turn inward, sit on the pity pot, sink into a depression or I could choose to become an advocate for life, to turn a theoretical ethics into a practical ethics, to become available for myself and for others. I chose the latter as being the only reasonable approach. I chose to live life on life’s terms. This is not to say that I didn’t make aggressive treatment choices, I did. A prostatectomy is major surgery even when done robotically. I chose this approach because it provided the best possibility for a long-term “cure,” although I don’t believe there is ever a “cure” for cancer, only a set of survival statistics, probabilities, percentages. If I understand my own mortality statistics, there is a 15% probability that I will die as a result of prostate cancer in the next ten years. Certainly nothing to go into a grand funk over. After all, I am 69 years old and I would think that I have around a 15% chance of dying from anything over the next ten years.

What this challenge has provided for me is something that I could not have anticipated, the ability to turn my humdrum lived-experience into an ethical one. This is not to say that daily living will not still be filled with routine, be commonplace, rather it means that I am always already present for the other. Here I Am! does not mean that sudden changes will occur in my life. To the contrary, I am creating proximate space that may or may not be addressed by the other (person) but the moment it is, the moment I hear the call of the other (person) I must act for the benefit of the other (person)…period. I see this ‘calling’ to be concentrated on benefiting prostate cancer patients but it is not limited to that sphere of influence. To be truly ethical it must not have walls to contain the effort. So, once again, Here I Am! I stand at the ready in proximity simply waiting to be called.

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